Individual provider Active NPI

Candice Marie Melara, OD

  • Optometrist
  • Aberdeen, WA
National Provider Identifier
1902916703
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003840 Issued in WA
Practice address
207 S Chehalis St
Aberdeen, WA 98520-2945
Phone
(360) 533-2020
Fax
(360) 533-1978
NPI assigned
Aug 30, 2006
Last updated
Jun 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2933AT OR
Optometrist 152W00000X OD00003840 WA Primary

Addresses

Primary practice location

207 S Chehalis St
Aberdeen, WA 98520-2945

Mailing address

207 S Chehalis St
Aberdeen, WA 98520-2945
Phone (360) 533-2020

Other names 1

  • Candice Marie Sherwin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000455 WA Practitioner - Optometry 5698757425 Practice locations: Kelso, WA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1704 Allen St
Kelso, WA 98626-4907
Phone (360) 577-0606

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2933ATORMDOptometrist
OD00003840WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Harbors Eye Center PS Past Accepting new patients
Twin Harbors Eye Center PS Optometrist PastSince Apr 1, 1998 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1902916703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S CHEHALIS ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985202945",
            "telephone_number": "360-533-2020",
            "fax_number": "360-533-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S CHEHALIS ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985202945",
            "telephone_number": "360-533-2020",
            "fax_number": "360-533-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELARA",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2933AT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "SHERWIN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.